Historical Provider Relationship definition

Historical Provider Relationship. A Provider who has been the main source of Demonstration, Medicaid or PeachCare for Kids® services for the Member or P4HB Participant during the previous year (decided on by the most recent Provider on the Member’s or P4HB Participant’s claim history). Immediately: Within twenty-four (24) hours. In-Network Provider: A Provider that has entered into a Provider Contract with the Contractor to provide services.
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Historical Provider Relationship. A Provider who has been the main source of Medicaid or PeachCare for Kids services for the Member during the previous year (decided on by the most recent provider on the member’s claim history). Immediately: Within twenty-four (24) hours. In-Network Provider: A Provider that has entered into a Provider Contract with the Contractor to provide services.
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Historical Provider Relationship. A Provider who has been the main source of Medicaid or PeachCare for Kids™ services for the Member during the previous year (decided on by the most recent provider on the member’s claim history). Health Information Technology for Economic and Clinical Health Act (HITECH Act) Title IV: The legislation establishes a transparent and open process for the development of standards that will allow for the nationwide electronic exchange of information between doctors, hospitals, patients, health plans, the government and others by the end of 2009. It establishes a voluntary certification process for health information technology products. The National Institute of Standards and Technology will provide for the testing of such products to determine if they meet the national standards that allow for the secure electronic exchange and use of health information. Immediately: Within twenty-four (24) hours. In-Network Provider: A Provider that has entered into a Provider Contract with the Contractor to provide services.
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Examples of Historical Provider Relationship in a sentence

  • Members will not be Auto-Assigned to a CMO plan unless a family member is enrolled in the CMO plan or a Historical Provider Relationship exists with a Provider that does not participate in any other CMO plan in the Service Region.

  • Members will not be Auto-Assigned to a CMO plan unless a family member is enrolled in the CMO plan or a Historical Provider Relationship exists with a Provider that does not participate in any other CMO plan in the Atlanta Service Region.

  • Thedimensions of these data sets range from 2 to 60, the numbers of training samples range from 140 to 1300, and the numbers of test samples range from 75 to 7000.T N Detailed information about these data sets can be found inD = 1 X X d (x ).

  • Members or P4HB Participants will not be Auto-Assigned to a CMO plan that exceeds this threshold unless a family member or P4HB Participant is enrolled in the CMO plan or a Historical Provider Relationship exists with a Provider that does not participate in any other CMO plan in the Service Region.

  • Members will not be Auto-Assigned to a CMO plan that exceeds this threshold unless a family member is enrolled in the CMO plan or a Historical Provider Relationship exists with a Provider that does not participate in any other CMO plan in the Service Region.

Related to Historical Provider Relationship

  • Customer relationship means a continuing relationship between a consumer and a licensee under which the licensee provides one or more insurance products or services to the consumer that are to be used primarily for personal, family or household purposes.

  • Bona fide physician-patient relationship means a treatment or counseling relationship between a physician and patient in which all of the following are present:

  • Service Relationship means any relationship as a full-time employee, part-time employee, director or other key person (including Consultants) of the Company or any Subsidiary or any successor entity (e.g., a Service Relationship shall be deemed to continue without interruption in the event an individual’s status changes from full-time employee to part-time employee or Consultant).

  • Direct relationship means that the nature of criminal conduct for which the person was convicted has a direct bearing on his fitness or ability to perform one or more of the duties or responsibilities necessarily related to the license, opportunity, or job in question.

  • Established business relationship means a relationship between a seller and a consumer based on:

  • Dating relationship means frequent, intimate associations primarily characterized by the expectation of affectional involvement. Dating relationship does not include a casual relationship or an ordinary fraternization between 2 individuals in a business or social context.

  • Business Relationship Strength for the purpose of this RFP shall mean the definition and commitment of the respondent towards a mutually successful “relationship” between the selected contractor and HCC for the duration of the contract. Respondent’s Statement of Qualification must include their definition, proposal and commitment to forge, foster and maintain a mutually successful “relationship” with HCC. At a minimum, your response must include:

  • Significant relationship means a situation in which the actor is: (1) the complainant's parent, stepparent, or guardian; (2) any of the following persons related to the complainant by blood, marriage, or adoption: brother, sister, stepbrother, stepsister, first cousin, aunt, uncle, nephew, niece, grandparent,great-grandparent, great-uncle, great-aunt; or (3) an adult who jointly resides intermittently or regularly in the same dwelling as the complainant and who is not the complainant's spouse. Minn. Stat. § 609.341(15).At what age is a person able to consent?18 years old. Idaho Statutes §§ 18-6101. At what age is a person able to consent?17 years old. 720 ILCS 5/11-1.60. However, if the actor is 17 years of age or older and holds a position of trust, authority, or supervision in relation to the victim, then the age of consent is 18 years old. At what age is a person able to consent?16 years old. IC §§ 35-42-4-9. At what age is a person able to consent?16 years old. I.C.A. § 709.4. At what age is a person able to consent?16 years old. K.S.A. 21-5506; 5507*.*Note: KSA 21-5507 was held to violate the equal protection provisions of the Fourteenth Amendment to the United States Constitution and§ 1 of the Kansas Constitution Bill of Rights to the extent that it results in a punishment for unlawful voluntary sexual conduct between members of the opposite sex that is less harsh than the punishment for the same conduct between members of the same sex. The court struck the phrase “and are members of the opposite sex” from the statute. State v. Limon, 280 Kan. 275, 276, 122 P.3d 22, 24 (2005). Proposed legislation would remedy this. See 2019 KS H.B. 2270 (NS). At what age is a person able to consent?18 years old.A person is deemed incapable of consent when he or she is: less than sixteen (16) years old; orsixteen (16) or seventeen (17) years old and the actor at least ten (10) years older than victim at the time of the sexual act.KRS § 510.020. At what age is a person able to consent?16 years old. Connecticut General Statutes Annotated §§ 53a-71. At what age is a person able to consent?16 years old, if the defendant is more than 4 years older, otherwise 18 years old. 11 Delaware Code §§ 761; 762; 765; 770; 771; 778.If the victim is at least 12 years old and the defendant is no more than 4 years older than the victim, it is an affirmative defense if the victim consented to the act “knowingly”. At what age is a person able to consent?16 years old. D.C. Code § 22-3001(3). At what age is a person able to consent?18 years old. Florida Statutes §§ 794.011; 794.05. At what age is a person able to consent?16 years old. Georgia Code § 16-6-3(a).

  • Medical provider means a medical service provider, a hospital, a medical clinic, or a vendor of medical services.

  • Account Information Service Provider means a payment service provider pursuing business activities as referred to in point (8) of Annex I;

  • Provider network means an affiliated group of varied health care providers that is established to provide a continuum of health care services to individuals;

  • Intimate relationship means a relationship between spouses, former spouses, past or present unmarried couples, or persons who are both the parents of the same child regardless of whether the persons have been married or have lived together at any time.

  • energy service provider means a natural or legal person who delivers energy services or other energy efficiency improvement measures in a final customer’s facility or premises;

  • Information Service Provider A provider of Information Service. Information Service Provider includes, but is not limited to, Internet Service Providers (ISPs).

  • Relationship means any interest, service, employment, gift, or other benefit or relationship with an entity that would be prohibited by Title 5, Subtitle 5 of the State's Public Ethics Law if not disclosed and approved pursuant to this Policy and procedures adopted pursuant to it. "Relationship" includes any relationship of the spouse or other relative of an officer or employee if such relationship creates restrictions on the officer or employee under the conflict of interest provisions of the Ethics Law.

  • Personal relationship means an ongoing romantic or intimate personal relationship that can include, but is not limited to, dating, living together or being a partner or significant other. This definition applies regardless of gender, gender identification, or sexual orientation of the individuals in the relationship. This restriction does not extend to friends, acquaintances or former colleagues who are not otherwise encompassed in the scope of “personal relationships.”

  • Internet Service Provider (ISP) means an Enhanced Service Provider (ESP) that provides Internet Services.

  • financial service provider means a person engaged in the business of providing financial services in terms of authorisation issued or registration granted by a financial sector regulator;

  • Health-related services means services that may have an effect on the health of individuals but are not health services or social care services;

  • Non-Network Provider means any hospital, day care centre or other provider that is not part of the network.

  • Family relationship means a relationship between a person and another person within the third degree by consanguinity or the second degree by affinity, as those terms are defined by Subchapter B, Chapter 573, Texas Government Code.

  • material relationship means one actually known of a personal, familial or business nature between the Broker and affiliated licensees and a client which would impair their ability to exercise fair judgment relative to another client.

  • Education service provider means an education management organization, school

  • Service Planning Team or “SPT” means a team who includes the Individual and/or the Individual’s identified support network, Contractor’s lead administrative staff supporting medical, behavioral and activity oversight called out in this Contract, Contractor’s Administrator or designee and ODHS Designee. The team is responsible for overseeing the Individual’s Service Plan and all other associated plans or services in this Contract.

  • Professional Provider means a Physician, Dentist, Podiatrist, Psychologist, Chiropractor, Optometrist or any Provider designated by the Claim Administrator or another Blue Cross and/or Blue Shield Plan.

  • Material Financial Relationship means a relationship in which one person is a recipient of any kind of payment such as by way of a loan or gift during the immediately preceding twelve months, equivalent to at least 25% of such payer’s annual income but shall exclude relationships in which the payment is based on arm’s length transactions.